摘要
目的:探讨血清免疫球蛋白(Ig)、叉头/翼状螺旋转录因子P3(Foxp3)水平与晚期非小细胞肺癌(NSCLC)患者纳武单抗治疗效果的关系。方法:选取衡水市人民医院2020年1月至2024年1月收治的晚期NSCLC患者180例作为NSCLC组,同期体检的180例健康志愿者作为健康组,检测血清IgA、IgM、IgG、Foxp3水平,比较两组血清IgA、IgM、IgG、Foxp3水平差异及晚期NSCLC患者不同临床特征中以上指标水平差异。晚期NSCLC患者均在紫杉醇、卡铂化疗基础上给予纳武单抗治疗,根据疗效分为治疗有效组(n=82)、治疗无效组(n=98),比较两组血清IgG、Foxp3水平差异,分析血清IgG、Foxp3预测晚期NSCLC患者纳武单抗治疗效果的效能。结果:NSCLC组血清IgG、Foxp3水平高于健康组(P<0.05),两组血清IgA、IgM水平差异无统计学意义(P>0.05)。TNM分期Ⅳ期、低分化NSCLC患者血清IgG、Foxp3水平高于Ⅲ期NSCLC患者(P<0.05)。治疗无效组TNM分期Ⅳ期、低分化比例及血清IgG、Foxp3水平高于治疗有效组(P<0.05)。Logistic回归分析显示:分化程度、高IgG、高Foxp3水平是晚期NSCLC患者纳武单抗治疗无效的危险因素(P<0.05)。血清IgG、Foxp3联合对晚期NSCLC患者纳武单抗治疗效果的预测效能优于任一单项,AUC为0.978,敏感度为96.75%、特异度为92.13%。结论:晚期NSCLC患者血清IgG、Foxp3水平升高,是纳武单抗治疗无效的危险因素,可作为预测患者纳武单抗治疗效果的参考指标。
Objective:To investigate relationship between serum immunoglobulin(Ig),forkhead box protein P3(Foxp3)and therapeutic effect of nivolumab in patients with advanced non-small cell lung cancer(NSCLC).Methods:A total of 180 advanced NSCLC patients admitted to Hengshui People's Hospital between January 2020 and January 2024 were selected as NSCLC group,and 180 healthy individuals who underwent physical examinations during same period were selected as healthy group.Serum IgA,IgM,IgG and Foxp3 levels were measured,and differences in serum IgA,IgM,IgG and Foxp3 levels between two groups were compared,as well as their differences of levels in different clinical characteristics of advanced NSCLC patients.Advanced NSCLC patients were treated with nivolumab on basis of paclitaxel and carboplatin chemotherapy,and divided into treatment effective group(n=82)and treatment ineffective group(n=98)based on efficacy.Differences of serum IgG and Foxp3 levels between two groups were compared,and efficacy of serum IgG and Foxp3 in predicting therapeutic effect of nivolumab in advanced NSCLC patients was analyzed.Results:Serum IgG and Foxp3 levels in NSCLC group were higher than healthy group(P<0.05),and there was no statistically significant difference in serum IgA and IgM levels between two groups(P>0.05).Serum IgG and Foxp3 levels in TNM stageⅣand poorly differentiated NSCLC patients were higher than stageⅢNSCLC patients(P<0.05).TNM stageⅣ,proportion of low differentiation,and serum IgG and Foxp3 levels in ineffective group were higher than effective group(P<0.05).Logistic regression analysis showed that differentiation level,high IgG and high Foxp3 levels were risk factors for ineffective treatment with nivolumab in advanced NSCLC patients(P<0.05).Predictive efficacy of combination of serum IgG and Foxp3 in treatment of advanced NSCLC patients with nivolumab was superior to any single therapy,with an AUC of 0.978,sensitivity of 96.75%,and specificity of 92.13%.Conclusion:Elevated serum IgG and Foxp3 levels in patients with advanced NSCLC are risk factors for nivolumab treatment failure,and can be used as a reference index to predict therapeutic effect of nivolumab.
作者
王海志
张红
郭晓蘅
张长庚
李娜
WANG Haizhi;ZHANG Hong;GUO Xiaoheng;ZHANG Changgeng;LI Na(Hengshui People's Hospital,Hengshui 053099,China)
出处
《中国免疫学杂志》
北大核心
2025年第2期413-417,共5页
Chinese Journal of Immunology
